{"id":7567,"date":"2022-11-22T13:00:22","date_gmt":"2022-11-22T10:00:22","guid":{"rendered":"https:\/\/urbancare.clinic\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\/"},"modified":"2022-11-22T13:00:22","modified_gmt":"2022-11-22T10:00:22","slug":"hyperkaliamie-bei-diabetes-neue-erkenntnisse-zu-mechanismus-und-behandlung","status":"publish","type":"post","link":"https:\/\/urbancare.clinic\/de\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\/","title":{"rendered":"Hyperkali\u00e4mie bei Diabetes: Neuere Erkenntnisse zu Mechanismus und Behandlung"},"content":{"rendered":"<div><img decoding=\"async\" src=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg\" class=\"ff-og-image-inserted\" style=\"display:none\"><\/div>\n<p><span class=\"highwire-journal-article-marker-start\"><\/span><\/p>\n<p id=\"p-1\">Hyperkali\u00e4mie ist eine problematische Komplikation bei Diabetes, die in fr\u00fchen Stadien einer diabetischen Nierenerkrankung auftreten kann. Hyperkali\u00e4mie wird oft als Serumkaliumwert \u00fcber 5,5 mmol\/L definiert, aber einige Studien deuten sogar darauf hin, dass Serumkaliumwert \u00fcber 5,0 mmol\/L eine Hyperkali\u00e4mie darstellen sollte.<span class=\"xref-bibr\">1<\/span> Es hat nicht nur kardiovaskul\u00e4re Auswirkungen mit einer Pr\u00e4disposition f\u00fcr Herzrhythmusst\u00f6rungen, sondern schlie\u00dft auch die Verwendung von Arzneimitteln aus, von denen bekannt ist, dass sie das Fortschreiten einer Nierenerkrankung bei Diabetes verhindern, einschlie\u00dflich ACE\/Angiotensin-Rezeptor-Blocker (ARB) und Mineralokortikoid-Rezeptor-Antagonisten. Andere Medikamente wie Trimethoprim, das bei Harnwegsinfektionen eingesetzt wird, und Heparin (insbesondere die unfraktionierte Form) k\u00f6nnen ebenfalls mit Hyperkali\u00e4mie in Verbindung gebracht werden.<span class=\"xref-bibr\">2<\/span> Die Pr\u00e4valenz von Hyperkali\u00e4mie bei Diabetikern mit normaler Nierenfunktion ist schwer zu interpretieren, da Serumkreatinin nicht der ideale Marker zur Beurteilung der Nierenfunktion ist. In einer Studie mit 1764 Patienten, die \u00fcber einen Zeitraum von 12 Monaten eine Diabetikerklinik aufsuchten, gaben 15% der Patienten an, einen Kaliumwert von &gt;5,0 mmol\/L zu haben, was deutlich h\u00f6her ist als in der Allgemeinbev\u00f6lkerung.<span class=\"xref-bibr\">1<\/span> Wir diskutieren hier die Mechanismen, die bei Diabetes zu Hyperkali\u00e4mie f\u00fchren k\u00f6nnen, was f\u00fcr die Behandlung dieser Erkrankung von Bedeutung ist.<\/p>\n<p id=\"p-2\">Warum kommt es bei Diabetes zu einer Hyperkali\u00e4mie?<\/p>\n<p id=\"p-3\">(1) Hyporenin\u00e4mischer Hypoaldosteronismus<\/p>\n<p id=\"p-4\">Es ist bekannt, dass Diabetes mit einem hyporenin\u00e4mischen Hypoaldosteronismus einhergeht, der zu einer Hyperkali\u00e4mie f\u00fchren kann, die in keinem Verh\u00e4ltnis zum Nierenversagen steht.<span class=\"xref-bibr\">3<\/span> Verschiedene Mechanismen, die f\u00fcr den hyporenin\u00e4mischen Hypoaldosteronismus bei Diabetes postuliert werden, werden in Algorithmus 1 dargestellt.<span class=\"xref-bibr\">4<\/span> (Abbildung 1)<\/p>\n<div id=\"F1\" class=\"fig pos-float odd\" readability=\"6\">\n<div class=\"fig-caption\" readability=\"7\"><span class=\"fig-label\">Abbildung 1<\/span> <\/p>\n<p id=\"p-5\" class=\"first-child\">Der Mechanismus, der bei Diabetes zu hyporenin\u00e4mischem Hypoaldosteronismus f\u00fchren kann.<\/p>\n<\/div>\n<\/div>\n<p id=\"p-6\">(2) Natriumabsorption \u00fcber proximale Tubuli und elektroneutrale Wege<\/p>\n<p id=\"p-7\">Der \u2026 <\/p>\n<p><span class=\"highwire-journal-article-marker-end\"><\/span><a href=\"http:\/\/pmj.bmj.com\/cgi\/content\/short\/98\/1166\/e45?rss=1\">Medizinische t\u00e4gliche Quelle<\/a><\/p>\n<p>","protected":false},"excerpt":{"rendered":"<p>Hyperkali\u00e4mie ist eine l\u00e4stige Komplikation bei Diabetes, die in fr\u00fchen Stadien einer diabetischen Nierenerkrankung auftreten kann. Hyperkali\u00e4mie wird oft als Serumkaliumwert \u00fcber 5,5 mmol\/l definiert, aber einige Studien legen sogar nahe, dass Serumkaliumwerte \u00fcber 5,0 mmol\/l als Hyperkali\u00e4mie gelten.<cross-ref type=\"bib\" refid=\"R1\">1<\/cross-ref> Es hat nicht nur kardiovaskul\u00e4re Auswirkungen mit einer Pr\u00e4disposition f\u00fcr Herzrhythmusst\u00f6rungen, sondern schlie\u00dft auch die Verwendung von Arzneimitteln aus, von denen bekannt ist, dass sie das Fortschreiten einer Nierenerkrankung bei Diabetes verhindern, einschlie\u00dflich ACE\/Angiotensin-Rezeptor-Blocker (ARB) und Mineralokortikoid-Rezeptor-Antagonisten. Andere Medikamente wie Trimethoprim, das bei Harnwegsinfektionen eingesetzt wird, und Heparin (insbesondere die unfraktionierte Form) k\u00f6nnen ebenfalls mit Hyperkali\u00e4mie in Verbindung gebracht werden.<cross-ref type=\"bib\" refid=\"R2\">2<\/cross-ref> Die Pr\u00e4valenz von Hyperkali\u00e4mie bei Diabetikern mit normaler Nierenfunktion ist schwer zu interpretieren, da Serumkreatinin nicht der ideale Marker zur Beurteilung der Nierenfunktion ist. In einer Studie mit 1764 Patienten, die \u00fcber 12 Monate eine diabetische Klinik besuchten, berichteten 15% der Patienten, dass sie \u2026<\/p>","protected":false},"author":2,"featured_media":7568,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"Default","format":"standard","meta":{"page_builder":"","fifu_image_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg","fifu_image_alt":"","footnotes":""},"categories":[185],"tags":[],"class_list":["post-7567","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-medical-articles"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Hyperkalemia in diabetes: newer insights into mechanism and treatment - Urban Care Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbancare.clinic\/de\/hyperkaliamie-bei-diabetes-neue-erkenntnisse-zu-mechanismus-und-behandlung\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hyperkalemia in diabetes: newer insights into mechanism and treatment - Urban Care Clinic\" \/>\n<meta property=\"og:description\" content=\"Hyperkalemia is a troublesome complication in diabetes which may present in early stages of diabetic kidney disease. Hyperkalemia is often defined as serum potassium more than 5.5 mmol\/L, but some studies even suggest serum potassium above 5.0 mmol\/L should qualify for hyperkalemia.1 Not only does it have cardiovascular implications with predisposition to cardiac arrhythmia but it also precludes the use of drugs known to prevent the progression of renal disease in diabetes including ACE\/angiotensin receptor blocker (ARB) and mineralocorticoid receptor antagonist. Other drugs like trimethoprim, which is used for urinary tract infection, and heparin (especially the unfractioned form) may also be associated with hyperkalemia.2 Prevalence of hyperkalemia in diabetics with normal renal functions is difficult to interpret as serum creatinine is not the ideal marker to assess kidney function. In one study among 1764 patients attending diabetic clinic over 12 months, 15% of patients reported to have...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/urbancare.clinic\/de\/hyperkaliamie-bei-diabetes-neue-erkenntnisse-zu-mechanismus-und-behandlung\/\" \/>\n<meta property=\"og:site_name\" content=\"Urban Care Clinic\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/urbancarezanzibar\" \/>\n<meta property=\"article:published_time\" content=\"2022-11-22T10:00:22+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"1024\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Urban Care Clinic\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Urban Care Clinic\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"1\u00a0Minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\"},\"author\":{\"name\":\"Urban Care Clinic\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#\\\/schema\\\/person\\\/a304a61bcf298680ee41e2e9ae193930\"},\"headline\":\"Hyperkalemia in diabetes: newer insights into mechanism and treatment\",\"datePublished\":\"2022-11-22T10:00:22+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\"},\"wordCount\":252,\"publisher\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/urbancare.clinic\\\/wp-content\\\/uploads\\\/2023\\\/02\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment.jpg\",\"articleSection\":[\"Research Articles\"],\"inLanguage\":\"de\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\",\"url\":\"https:\\\/\\\/urbancare.clinic\\\/hyperkalemia-in-diabetes-newer-insights-into-mechanism-and-treatment\\\/\",\"name\":\"Hyperkalemia in diabetes: newer insights into mechanism and treatment - 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Hyperkalemia is often defined as serum potassium more than 5.5 mmol\/L, but some studies even suggest serum potassium above 5.0 mmol\/L should qualify for hyperkalemia.1 Not only does it have cardiovascular implications with predisposition to cardiac arrhythmia but it also precludes the use of drugs known to prevent the progression of renal disease in diabetes including ACE\/angiotensin receptor blocker (ARB) and mineralocorticoid receptor antagonist. Other drugs like trimethoprim, which is used for urinary tract infection, and heparin (especially the unfractioned form) may also be associated with hyperkalemia.2 Prevalence of hyperkalemia in diabetics with normal renal functions is difficult to interpret as serum creatinine is not the ideal marker to assess kidney function. 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